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Serum Potassium and Risk of Cardiovascular Disease
The Framingham Heart Study
Craig R. Walsh, MD;
Martin G. Larson, ScD;
Eric P. Leip, MS;
Ramachandran S. Vasan, MD, DM;
Daniel Levy, MD
Arch Intern Med. 2002;162:1007-1012.
Background Published studies of the association between serum potassium concentration
and risk for cardiovascular disease in community-based populations have reported
conflicting results. We sought to determine the association between serum
potassium concentration and cardiovascular disease risk in the Framingham
Heart Study.
Methods A total of 3151 participants (mean age, 43 years; 48% men) in the Framingham
Heart Study who were free of cardiovascular disease and not taking medications
affecting potassium homeostasis had serum potassium levels measured (1979-1983).
Proportional hazards models were used to determine the association of serum
potassium concentration at baseline with the incidence of cardiovascular disease
at follow-up.
Results During mean follow-up of 16 years, 313 cardiovascular disease events
occurred, including 46 cardiovascular disease–related deaths. After
adjustment for age, serum potassium level was marginally associated with risk
of cardiovascular disease (hazard ratio [HR] per 1 mg/dL increment, 1.03;
95% confidence interval [CI], 1.00-1.05; P = .02).
However, after further adjustment for multiple confounders, serum potassium
level was not significantly associated with cardiovascular disease risk (HR,
1.00; 95% CI, 0.98-1.03). There were no significant associations between serum
potassium level and cardiovascular disease–related death in either age-
and sex-adjusted models (HR, 1.06; 95% CI, 0.99-1.12) or multivariable-adjusted
models (HR, 1.04; 95% CI, 0.97-1.11).
Conclusion In our community-based sample of individuals free of cardiovascular
disease and not taking medications that affect potassium homeostasis, serum
potassium level was not associated with risk of cardiovascular disease.
From the National Heart, Lung, and Blood Institute's Framingham Heart
Study, National Institutes of Health, Framingham, Mass (Drs Walsh, Larson,
Vasan, and Levy and Mr Leip); the Cardiology Division, Department of Medicine,
Massachusetts General Hospital (Dr Walsh), and the Department of Medicine,
Beth Israel–Deaconess Medical Center (Dr Levy), Harvard Medical School,
Boston; and the Section of Epidemiology and Preventive Medicine, Evans Department
of Medicine, Boston University School of Medicine (Drs Larson, Vasan, and
Levy and Mr Leip).
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